Tuesday, April 23, 2024, 2:10 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
Can you submit two claims forms to void/replace a ten-line claim?Yes you can, as long as it is not a duplicate claim or void only; then, refile a 4-line and 6-line claim. |
Will the system distinguish that a company has multiple provider numbers?Yes, make sure all their information is correct when completing the claim form. |
Do you file to another payer when you know services are not covered?Yes, this is considered a valid denial. |
What if you know any other office has a claim waiting to be filed that uses the same visit counts you will be using to file a claim for a beneficiary?You should also file right away. Area representatives can approve a few extra visits, but not every time. |
Do you have to ask MIVS to research TPL non-payment?No, they do this on their own to ensure payment. |
Can you accept a beneficiary as just a private pay patient even if they have Medicaid?Yes, you just have to let them know before they receive any services. |
Does the Medicaid card have all the information needed?No, you should further investigate eligibility using eligibility resources and the information provided on the card. |
If I send a HIIRF, will I see anything saying it was received?No, just wait a few days and check eligibility again. |
If a Health Insurance Information Referral Form (HIIRF) is completed with no documentation, will the beneficiary's TPL record be updated?No, MIVS will further investigate and draft a letterhead showing steps taken. |
What do you do if monies are sent to the patient?Change them to self pay after or before service completion. |